Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.50 / $92.82 / $378.59	Facility	26	$62.50	$92.82	$378.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $425.00 / $810.00	Professional		$250.00	$425.00	$810.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.50 / $129.19 / $317.64	Professional	26	$62.50	$129.19	$317.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $187.50 / $282.87 / $440.00	Professional	TC	$187.50	$282.87	$440.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $157.72 / $227.49 / $497.17	Professional		$157.72	$227.49	$497.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $80.69 / $142.04 / $229.44	Professional	26	$80.69	$142.04	$229.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $184.14 / $184.14 / $184.14	Professional	TC	$184.14	$184.14	$184.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $124.22 / $124.22 / $331.68	Facility	26	$124.22	$124.22	$331.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.36 / $491.02 / $1,285.92	Professional		$240.36	$491.02	$1,285.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.95 / $128.13 / $231.51	Professional	26	$76.95	$128.13	$231.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $161.21 / $340.34 / $1,108.93	Professional	TC	$161.21	$340.34	$1,108.93
Florida Blue Facility/Professional Facility Modifier 26 Low / Median / High Price $121.52 / $121.52 / $121.52	Facility	26	$121.52	$121.52	$121.52
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $286.67 / $459.65 / $986.36	Professional		$286.67	$459.65	$986.36
Florida Blue Facility/Professional Professional Modifier 26 Low / Median / High Price $85.06 / $130.62 / $164.66	Professional	26	$85.06	$130.62	$164.66
Florida Blue Facility/Professional Professional Modifier TC Low / Median / High Price $197.84 / $318.39 / $859.45	Professional	TC	$197.84	$318.39	$859.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $209.28 / $387.38	Professional		$95.09	$209.28	$387.38
United Facility/Professional Professional Modifier Low / Median / High Price $287.94 / $448.11 / $1,052.83	Professional		$287.94	$448.11	$1,052.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $88.17 / $105.08 / $214.49	Professional	26	$88.17	$105.08	$214.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.17 / $291.26 / $766.62	Professional	TC	$194.17	$291.26	$766.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $236.78 / $236.78 / $236.78	Professional		$236.78	$236.78	$236.78
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $77.25 / $77.25 / $77.25	Professional	26	$77.25	$77.25	$77.25
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $159.53 / $159.53 / $159.53	Professional	TC	$159.53	$159.53	$159.53